Model-based assessment of pressure and flow-dependent coronary responses following abrupt pressure drops.

The response of the coronary vasculature to an experimental manoeuvre of step-like decrease of the perfusion pressure has been investigated with a model. The coronary vasculature was simulated using a 'windkessel' scheme. Proximal resistance and compliance were assumed to be pressure-independent. The distal resistance, on the contrary, was controlled by a feed-back loop which accounts for the smooth muscle activation induced by the pressure variation. Three more parameters were introduced, and namely the smooth muscle activation time constant and the pressure-induced and flow-induced gains. The parameter values were assessed by comparing the model predicted coronary flow with the one actually measured in animals.

The heart rate after inhibition of nitric oxide release in the anaesthetized dog.

1. The effect of nitric oxide (NO) inhibition on heart rate was studied in anaesthetized vagotomized dogs. 2. The effect of changes of baroreceptor stimulation was prevented using an arterial pressure reservoir. 3. After NO-inhibitor (Nitro-L-arginine), heart rate decreased by 8% in spite of an unchanged pressure. 4. When upstream pressure was increased by constriction of the descending aorta, heart rate decreased by 4% before and after inhibition. Owing to the vagotomy this decrease was attributed to a sympathetic tone reduction following baroreceptor stimulation. 5. The results show that NO-inhibition reduces heart rate independently of an increased baroreceptor stimulation and does not reduce the basal sympathetic control on the sinus-atrial node.

The role of nitric oxide in the initiation and in the duration of some vasodilator responses in the coronary circulation.

In the coronary bed vasodilation can be mediated by several mechanisms including endothelium-produced nitric oxide. To examine the contribution of nitric oxide, three different techniques to cause vasodilation in the coronary vessels were used in the anaesthetized dog: intracoronary injection of 1 microgram acetylcholine, sudden reduction of the aortic blood pressure inducing a myogenic response and transient occlusion followed by release of the left circumflex coronary artery causing reactive hyperaemia. Each manoeuvre was performed before and after intracoronary administration of 100 mg N-nitro-L-arginine, an inhibitor of the synthesis of nitric oxide. In contrast to previous investigations, the inhibition of nitric oxide synthesis was prevented from causing an increase in blood pressure by the use of a blood-pressure-compensating device. The results observed during each of the three techniques, suggest that the initial cause of the vasodilatation is not the result of the increase of the production of nitric oxide. However, subsequent to the initiation of vasodilation, an increase in the shear stress can result in an increase in the release of nitric oxide from the vascular endothelium, thus prolonging the vasodilatation obtained using each technique.

Heart rate decrease after inhibition of nitric oxide release in the anaesthetized dog.

In 5 anaesthetized vagotomized dogs the administration of an inhibitor of the synthesis of nitric oxide (NO) was seen to reduce the heart rate, although the arterial pressure was prevented from increasing. Such a finding suggests that the inhibition of nitric oxide release can produce bradycardia without the involvement of baroreceptor reflexes. Since NO inhibition is known to increase the concentration of adenosine in the myocardium, in 3 additional dogs, dipyridamole, which also potentiates the effect of adenosine, was infused: a reduction in heart rate was observed also in these animals. In both groups of animals, before and after the administration of the relevant compound, the increase in ABP obtained with aortic constriction caused the same reduction in heart rate, which which was attributed to a reduction of the basal sympathetic discharge, which was shown not to be affected by NO inhibition. It is concluded that NO inhibition can cause bradycardia without the intervention of any nervous mechanism but with the possible intervention of an increase in myocardial adenosine concentration.

Endothelium and coronary reactive hyperaemia.

The effect of the inhibition of the endothelial release of nitric oxide (NO) on the hyperaemia which follows a 10 s coronary occlusion was studied in 5 anaesthetized dogs, keeping aortic blood pressure constant. The left circumflex coronary artery was occluded before and after the intracoronary infusion of an inhibitor of NO (LNNA). After LNNA, the peak amplitude of the hyperaemia was the same but the duration was reduced almost to a half of the control value; it is suggested that a myogenic vasodilatation is involved in the amplitude of the reactive hyperaemia, while the reduction in the duration of the hyperaemia after the inhibitor could result from the shear stress being less effective in causing the release of NO during the first part of the hyperaemia.